Summary & Overview
HCPCS Q4117: Hyalomatrix Wound Matrix, Per Square Centimeter
HCPCS Level II code Q4117 identifies Hyalomatrix billed per square centimeter as an add-on product used in advanced wound management. The code matters nationally as utilization of biologic and matrix products grows for managing complex wounds, surgical sites, and chronic ulcers; appropriate coding ensures product-level capture for clinical tracking and reimbursement. Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise overview of the clinical role of Hyalomatrix, payer coverage context, and typical sites of service where the product is used. The publication summarizes benchmarks and coverage themes (where available), points to common billing practices for add-on HCPCS product codes, and outlines documentation and coding considerations relevant to hospital outpatient departments, wound care centers, and ambulatory settings. Data not available in the input will be noted explicitly. The piece is intended for coding professionals, billing managers, and clinical leaders who need a national-level reference for HCPCS Level II code Q4117.
Billing Code Overview
HCPCS Level II code Q4117 denotes Hyalomatrix, per square centimeter and is billed as an add-on, list separately in addition to primary procedure. The code represents a wound care product composed of a hyaluronic acid–based matrix used to support soft tissue regeneration and wound healing.
Service Type: Medical device/specialized wound care product
Typical Site of Service: Outpatient wound care clinics, hospital outpatient departments, ambulatory surgical centers, and other outpatient settings where advanced wound management is provided
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with a full-thickness or deep partial-thickness dermal injury such as a complex surgical wound, post-excisional defect (for example after wide local excision of a skin malignancy), or a non-healing traumatic wound where a bioengineered hyaluronic acid–based dermal matrix (Hyalomatrix) is used as an adjunct to standard wound management. The patient often presents to a hospital outpatient surgical clinic or an ambulatory surgery center for wound preparation and application of the matrix.
Clinical workflow: The wound is evaluated, debrided as needed, and hemostasis achieved. Appropriate irrigation and wound bed preparation are performed. The primary surgical or wound care procedure (such as debridement, excision, or skin grafting) is completed or planned; Q4117 is billed as an add-on to document placement of Hyalomatrix per square centimeter in addition to the primary wound procedure. The device is measured and applied to the wound, secured per manufacturer instructions, and covered with appropriate dressings. Follow-up visits assess integration of the matrix, need for additional grafting, and wound healing progression. Typical sites of service include hospital outpatient departments, ambulatory surgical centers, and specialized wound care clinics. Typical patient modifiers may reflect bilateral procedures, increased procedural complexity, or inability to tolerate anesthesia as clinically appropriate.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 |